童年创伤与青少年抑郁的关系:社会支持和应对方式的中介作用

Relationship between childhood trauma and adolescent depression:the mediating role of social support and coping styles

目的:探讨童年创伤、社会支持、应对方式与青少年抑郁之间的关系。方法:便利抽取2021年3月—8月某三级甲等医院精神卫生科住院的青少年抑郁症病人(n=196)和某学校年龄与之匹配的健康青少年(n=197)为研究对象,采用童年创伤问卷、社会支持评定量表、简易应对方式问卷和抑郁自评量表进行问卷调查,并分析童年创伤、社会支持、应对方式与青少年抑郁之间的关系。结果:抑郁组青少年童年创伤问卷、社会支持评定量表、简易应对方式问卷和抑郁自评量表得分分别为(49.590±11.266)分、(29.280±6.007)分、-0.791(-1.490,0.066)分、(72.666±10.767)分;青少年抑郁与社会支持和应对方式呈负相关,与童年创伤呈正相关;童年创伤与社会支持、应对方式呈负相关;社会支持与应对方式呈正相关。构建链式中介模型,童年创伤可以直接正向预测抑郁,也可以通过社会支持、应对方式分别预测抑郁,还可以通过社会支持和应对方式的多重中介预测抑郁,直接效应值为0.57、总中介效应值为0.30,总效应值为0.87,中介效应占总效应的34.48%。结论:童年创伤分别通过社会支持、应对方式的中介作用,以及社会支持和应对方式的链式中介作用影响青少年抑郁。通过加强青少年社会支持和引导青少年采取积极的应对方式,可降低青少年抑郁障碍的发病率。

Objective:To explore the relationship between childhood trauma,social support,coping style,and adolescent depression.Methods:Adolescent depression patients(n=196)in the mental health department of a tertiary hospital from March to August 2021 and age⁃matched healthy adolescents(n=197)in a school were selected as the research subjects.The Chinese version of Childhood Trauma Questionnaire⁃Short Form(CTQ⁃SF),Social Support Rating Scale(SSRS),Simplified Coping Style Questionnaire(SCSQ),and Self⁃Rating Depression Scale(SDS)were used to investigate the relationship between childhood trauma,social support,coping style,and adolescent depression.Results:The scores of CTQ⁃SF,SSRS,SCSQ,and SDS of adolescents in the depression group were(49.590±11.266)points,(29.280±6.007)points,-0.791(-1.490,0.066)points,and(72.666±10.767)points,respectively.Adolescent depression was positively correlated with social support and coping style and negatively correlated with childhood trauma;childhood trauma was negatively correlated with social support and coping style;social support was positively correlated with positive coping style.By constructing the chain mediation model,it showed that:childhood trauma can directly and positively predict depression and predict separately through social support and coping style;childhood trauma can predict depression through multiple mediators of social support and coping style,with a direct effect value of 0.57;total mediating effect value of 0.30;total effect value of 0.87;and the mediating effect accounted for 34.48%of the total effect.Conclusions:Childhood trauma affects adolescent depression through the mediating effect and the mediating chain effect of social support and coping style,respectively.The incidence of depressive disorder in adolescents could be reduced by strengthening adolescents'social support and guiding adolescents to adopt positive coping styles.